page_title: Casualty lifting
section_title: Rolling methods (log roll)
hierarchical_section_title: Casualty lifting / Rolling methods (log roll)
caption_attribution_description: Relevage à la cuiller. Auteur&#160;: Christophe Dang Ngoc Chan (Cdang), dessin original numérisé et retouché avec un logiciel de dessin.
context_page_description: Casualty lifting is the first step of casualty movement, an early aspect of emergency medical care. It is the procedure used to put the casualty on a stretcher.
  Developed emergency services use lifting devices, such as scoop stretchers, that allow secured lifting with minimal personnel. Other methods can be used when such devices are not available.
  Since only stabilised casualties are moved, the lifting is usually never performed in emergency; emergency movements are sometimes performed to respect the Golden Hour. This depends on the organisation of the medical services and on the specific circumstances.
  Maximum care must be taken to avoid to worsen an unstable trauma. The head-neck-chest axis must be kept straight to protect the spine, and the first responders must keep the patient's body stable during the lift.
  The first responders have to carry a heavy load in an uncomfortable position. There is thus a risk of injury to the carrier, especially of the lumbar back. To avoid an injury, they must push with their legs, trying to keep their back straight.
context_section_description: The rolling methods can only be used on a casualty who does not have an unstable trauma. They are especially helpful for heavy weighted casualties: the rolling does not require much effort, and the lifting itself is done in a more comfortable position (the back of the first responders is vertical). They are also interesting when the casualty is in a very narrow place such as a pit or a ditch: the rolling allows sliding the lifting device (board, flexible stretcher, halves of the scoop stretcher).
  The rolling methods consist in rolling the casualty on his/her side; it is then possible:
  to put a long spine board against his/her back, then to roll back the casualty on his/her back;
  to slide a folded flexible stretcher (or a blanket); the casualty is then rolled on the other side to unfold the flexible stretcher.
  The casualty can then be lifted with the handles of the long spine board or of the flexible stretcher (or holding the rolled sides of the blanket), and put on the stretcher.
  Usually, the method is done with four first responders, including the chief:
  the chief is kneeling at the head, in the axis of the casualty, and holds the head;
  the first team member is kneeling besides the casualty, and holds the opposite shoulder and the opposite hip;
  the second team member is kneeling at the feet, in the axis of the victim, and holds the ankles;
  at the order of the chief, the casualty is rolled towards the first team member, and the fourth team member puts the board or the flexible stretcher in place.
  This method can be adapted to place a casualty on a vacuum mattress (see this article).
  This method can also be performed by only two first responders: the chief plays the role of the first team member, and the only team member deals with the board (neither the head nor the ankles are gripped). This is rather traumatic for the casualty, but can be used when there is non suspicion of trauma, either in emergency (e.g. to transport a cardiac arrest when advanced life support cannot be performed on site), or when the first responders are lacking.
  The method with a flexible stretcher was inspired by the method used to change the sheets of an impotent patient at the hospital. The flexible stretcher is placed beside the casualty, and a sheet is put on it. The third of the stretcher that is the closest to the casualty is folded on the middle third. The casualty is first rolled away from the stretcher, and the stretcher is slid against the back of the casualty. Then the casualty is put on his/her back and rolled on the other side; the stretcher and the sheet are unfolded. The casualty is wrapped into the sheet, and can be lifted with the handles of the flexible stretcher.
  It is also possible to use a roll-and-lift method, or "spoon" lifting (relevage à la cuiller in French), with three people:
  the first responders are placed on the same side of the casualty; the knee that is closest to the head is lifted, the other one is on the ground;
  the chief is at the head; putting one arm under the neck and reaching the opposite shoulder, the other arm under the back;
  the first team member is besides the pelvis; having one arm under the back, one arm under the back, the other one under the thighs;
  the third team member supports the legs.
  At the order of the chief, the casualty is lifted and put on the lifted knees of the first responders. Then, the casualty is flattened against the chests, and the first responders stand up. They move towards the stretcher; there, they put one knee on the ground (the closest to the casualty's feet), lay the casualty on his/her back, and move the casualty from their knees to the stretcher. For this last movement, additional first responders can be placed at the opposite side of the stretcher to help the landing.
  The spoon lifting can also be used for emergency movements of a casualty when a spine trauma is suspected, e.g. the casualty is unconscious and is threatened by a fast rise of water level (flood).
caption: manual roll-and-lift method, or "spoon lifting", with three team members
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